NPI | 1275974073 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 111N00000X Chiropractor (Licence: SC 3838) |
Additional Taxonomies | 111NI0900X Chiropractor Internist (Licence: SC 3838) |
111NN1001X Chiropractor Nutrition (Licence: SC 3838) | |
111NR0400X Chiropractor Rehabilitation (Licence: SC 3838) | |
111NS0005X Chiropractor Sports Physician (Licence: SC 3838) | |
Enumeration Date | 2013-07-10 |
Last Update Date | 2013-07-10 |